Many people already know that a woman’s fertility sharply decreases beginning in her late 30s. But you may wonder if it’s “too late” to get pregnant after age 40. The answer to that question is complicated and takes into account many factors. Age factors are indeed very real, but sometimes we can work around them.
For many women, pregnancy is indeed still possible after age 40. However, achieving it requires some extra attention to your cycles and will bring some additional risks to your health if you do get pregnant. Dr. Edward J. Ramirez of The Fertility & Gynecology Center - Monterey Bay IVF explains more about the challenges and opportunities of getting pregnant after age 40.
What makes pregnancy after 40 harder to achieve
A woman’s fertility begins to decline sharply around age 35. Although this can be seen as bad news for women who have chosen to wait to begin their families, it’s just an unfortunate factor of the “biological clock.” This term is more than just a warning for older relatives who are hoping for grandchildren.
You’re born with all of the eggs that you will have in your lifetime. As you get nearer to the end of your fertile years, your eggs diminish both in number and quality. A healthy, fertile woman has a 20% chance of getting pregnant each month, while this number decreases to only 5% at age 40.
Men over age 40 also have an increased risk of contributing to a baby with congenital birth defects, including neurocognitive disorders and even childhood cancer.
Options for beating the clock
We do have quite a few options if you’ve found yourself nearing the end of your reproductive years.
The first thing we might do is order blood tests to determine your baseline levels of the following hormones:
- Follicle-stimulating hormone (FSH)
- Estradiol (E2), a measurement of estrogen
- Luteinizing hormone (LH)
- Thyroid-stimulating hormone (TSH)
- Free triiodothyronine (T3)
- Free thyroxin (T4)
- Dehydroandrosterone Sulfate (DHEAS)
- Sex hormone-binding globulin
- Fasting insulin
All of these blood tests are usually part of a standard fertility workup, but we may focus on certain hormones if we already know you have a deficiency, such as that caused by polycystic ovarian syndrome.
Managing the risks of pregnancy loss
Unfortunately, it’s also a fact that you’re at greater risk of pregnancy loss (or miscarriage) after age 40.
If you’re facing this situation, it’s understandably very heartbreaking. But you can improve your chances of carrying a pregnancy to full term.
We might do additional tests to try to determine the reason for your pregnancy losses, However, you also have more options to conceive.
Options for managing pregnancy over 40
If you want to get pregnant and you’re over 40, you still have options. Some of the options we may try as appropriate may include:
Fertility drugs and IUI
Taking fertility drugs, such as clomiphene citrate, can help to induce ovulation. In these cases, we’ll monitor your health to determine if and when ovulation is successful. When you do successfully ovulate, we may try performing intrauterine insemination (IUI) for up to 4 cycles.
In this procedure, we take either your partner’s sperm or donor sperm and insert it directly into your uterus. However, this procedure is usually more successful in patients 35 years old and younger.
In-vitro fertilization (IVF)
When you opt for in-vitro fertilization, you may use your own eggs or donor eggs. In this procedure, you will inject yourself with fertility-enhancing drugs (or the woman donating her eggs will get the injections.) These drugs stimulate your ovaries to produce eggs, but sometimes, you may produce multiple embryos, which can increase your odds of having multiple births, such as twins or triplets.
At the time of ovulation, we retrieve the eggs from the ovaries, where they are united with sperm in a petri dish. Once the eggs and sperm unite, we will transfer the developing embryo into your uterus.
If we’ve determined that pregnancy is unlikely to happen for you, you still have the option of using a gestational surrogate. This is hiring a third-party individual to carry your child to birth. We do not offer these services in our office, but we can certainly assist you in trying to select a surrogate, and we can manage their pregnancy care.
If you are over 40, your chances of having a child aren’t done. But you may need some assistance, and time is of the essence. Call Dr. Edward J. Ramirez at The Fertility & Gynecology Center - Monterey Bay IVF or request an online appointment today.